A pilot feasibility study of a tablet-based virtual community application with shared avatars for promoting health behavior change in older adult care facilities

Background Maintaining exercise and medication habits is crucial for older adults, but conventional reminder-based digital interventions often produce only transient effects. Methods We conducted a mixed-methods pilot feasibility study comparing a reminder-only intervention (Experiment 1, N = 10) with a healthcare community app combining reminders and avatar-based virtual social interaction (Experiment 2, N = 10) in older adult care facilities over 4-week baseline and 4-week intervention periods. Primary outcomes were daily step counts and medication adherence. Results The Reminder group showed a transient increase in step count in Week 1 (+16%) that declined to below baseline by Week 4 (−10.3%). In contrast, the Reminder + Support group maintained substantial step count improvements throughout the intervention (Week 4: +58.4%), with statistically significant differences at all time points. Medication adherence showed similar trends. A between-group comparison (Mann-Whitney U = 11.0, p < 0.05) supported greater efficacy of the Reminder + Support intervention. Qualitative data confirmed higher satisfaction and stronger social motivation in the Reminder + Support group. Conclusion These preliminary findings suggest that integrating avatar-based social interaction with reminder functions may support more sustained health behavior change in older adults than reminders alone, warranting confirmation in larger randomized trials.